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Background Sensitization to house dust mites (HDM) is frequent in patients with atopic dermatitis (AD). Objective To investigate the efficacy of sublingual immunotherapy (SLIT) with Dermatophagoides pteronyssinus(Dpt) extract in patients with AD sensitized to HDM. Methods In this randomized, double-blind, placebo-controlled trial, we enrolled 91 patients aged ≥3 years, with SCORing Atopic Dermatitis (SCORAD) ≥15 and positive skin test and/or IgE to Dpt. Patients were stratified according to age ( > 15-point decrease in SCORAD. Secondary outcomes were decreases in SCORAD and objective SCORAD (O-SCORAD), Eczema Area and Severity Index (EASI), visual analog scale (VAS) for symptoms, pruritus scale; Investigator’s Global Assessment (IGA) 0/1; and decrease ≥4 points in Dermatology Life Quality Index (DLQI). Background therapy was maintained. Results A total of 66 patients completed the study (35 HDM SLIT, 31 placebo). After 18 months, 74.2% and 58% patients in HDM SLIT and placebo groups, respectively, showed > 15-point decrease in SCORAD (relative risk[RR]1.28, 95% confidence interval[CI] 0.89-1.83). Significant SCORAD decreases from baseline of 55.6% and 34.5% in HDM SLIT and placebo groups (mean difference 20.4;95%CI 3.89-37.3); significant O-SCORAD decreases of 56.8% and 34.9% in HDM SLIT and placebo groups (mean difference 21.3;95%CI 0.66-41.81); and more patients with IGA 0/1 in HDM SLIT group as compared to placebo group (14/35 vs 5/31;RR 2.63, 95%CI 1.09-6.39), were observed at 18 months. Conclusion Our results suggest that HDM SLIT may be effective in HDM sensitized patients as an add-on treatment for AD.

ObjectiveTo evaluate the clinical efficacy of a mixture of probiotics (Lactobacillus and Bifidobacterium) in children and adolescents with atopic dermatitis (AD) and the effects on sensitization, inflammation, and immunological tolerance.MethodsIn this double-blind, randomized, placebo-controlled clinical trial, we enrolled 60 patients aged between 6 months and 19 years with mild, moderate, or severe AD, according to the criteria proposed by Hanifin and Rajka. Patients were stratified to receive one gram per day of probiotics or placebo for 6 months. The primary outcome was a decrease in SCORing Atopic Dermatitis (SCORAD). Secondary outcomes were to assess the role of probiotics on the use of topical and oral medicines (standard treatment), serum IgE levels, skin prick test (SPT), and tolerogenic and inflammatory cytokines. Background therapy was maintained.ResultsForty patients completed the study (24 probiotics, 16 placebo). After treatment for six months, the clinical response was significantly better in the probiotics group; the SCORAD decreased [mean difference (MD) 27.69 percentage points; 95% confidence interval (CI), 2.44–52.94], even after adjustment for co-variables (MD 32.33 percentage points; 95%CI, 5.52–59.13), especially from the third month of treatment on. The reduction of the SCORAD in probiotic group persisted for three more months after the treatment had been discontinued, even after adjustment for co-variables (MD 14.24 percentage points; 95%CI, 0.78–27.70). Patients in the probiotics group required topical immunosuppressant less frequently at 6 and 9 months. No significant changes were found for IgE levels, SPT and cytokines.ConclusionsChildren and adolescents with AD presented a significant clinical response after 6 months with a mixture of probiotics (Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus paracasei, and Bifidobacterium lactis. However, this clinical benefit is related to treatment duration. Probiotics should be considered as an adjuvant treatment for AD.

INTRODUCTION: We evaluated the performance of Bayesian vector autoregressive (BVAR) and Holt’s models to forecast the weekly COVID-19 reported cases in six units of a large hospital. METHODS: Cases reported from epidemiologic weeks (EW) 12-37 were selected as the training period, and from EW 38-41 as the test period. RESULTS: The models performed well in forecasting cases within one or two weeks following the end of the time-series, but forecasts for a more distant period were inaccurate. CONCLUSIONS: Both models offered reasonable performance in very short-term forecasts for confirmed cases of COVID-19.

Background: The hypothesis that early stimulation of the gut microbiota contributes to immune system balance has encouraged the use of probiotics to treat atopic dermatitis (AD), an immunological disorder characterized by chronic and relapsing skin inflammation, in several clinical studies. This study aimed to evaluate the clinical efficacy of a mixture of probiotics (Lactobacillus and Bifidobacterium) in children and adolescents with AD and the effects of probiotics on sensitization, inflammation, and immunological tolerance. Methods: In this double-blind, randomized, placebo-controlled clinical trial, children and adolescents (aged 2 to 19 years) received one gram (sachet) per day of probiotics or placebo for six months. SCOring of AD (SCORAD) index, serum IgE levels, skin prick test, tolerogenic and inflammatory cytokines were evaluated. Results: Forty patients were evaluated and clinical response was significantly better in the probiotic group as compared to the placebo group after treatment for six months; SCORAD decreased (95% CI, 2.44–52.94) even after adjustment for co-variables (95% CI, 5.52–59.13). Three months after the treatment was discontinued, improvement persisted in the probiotic group even after adjustment for co-variables (95% CI, 0.78– 27.70). IgE levels, skin prick test and cytokines did not differ between groups. Conclusions: AD children and adolescents treated with a mixture of probiotics (Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus paracasei, and Bifidobacterium lactis) for six months presented a significate SCORAD reduction as compared to placebo group. This probiotics mixture did not affect SPT and IgE levels, as well as inflammatory or tolerogenic cytokines. ClinicalTrials.gov #NCT02519556.

Ethnopharmacological relevance Roots of Curcuma longa L. are used as medicine for millennia. They possess several pharmacological properties, including anti-inflammatory action, and can be suitable for asthma treatment. Aim of the study We aimed to test the hypothesis that, in children and adolescents with persistent asthma, the administration of powdered roots of C. longa for 6 months, in addition to standard treatment, compared to placebo, will result in better disease control. Patients and methods We conducted a randomized, double-blind, placebo-controlled, phase II clinical trial. Patients were randomly assigned to receive 30 mg/kg/day of C. longa for 6 months, or placebo. Data were collected prospectively. All patients were categorized for asthma severity and control according to GINA-2016 and underwent pulmonary function tests. Results Overall, both groups experienced amelioration of their frequency of symptoms and interference with normal activity, but no differences were found between the two treatment groups. However, patients receiving C. longa experienced less frequent nighttime awakenings, less frequent use of short-acting β-adrenergic agonists, and better disease control after 3 and 6 months. Conclusion The powdered roots of C. longa led to less frequent nighttime awakenings, less frequent use of short-acting β-adrenergic agonists, and better disease control after 3 and 6 months, when compared to placebo.

From 2012 to 2013, 300 adults under investigation of tuberculous meningitis (TBM) were tested with polymerase chain reaction (PCR) in central spinal fluid (CSF), followed by TBM score calculation. There were 33(11%) confirmed TBM cases based on clinical findings, CSF-culture; biopsy/necropsy exams and clinical improvement after tuberculosis specific treatment. Other 267 adults were classified as non-TBM. Based on the original score there were 143 possible cases (6 ≤ score ≤ 11) and 20(60.6%) out of 33 TBM; among 27 probable TBM (score ≥ 12) there were 13/33 (39.4%) confirmed cases. The CSF-PCR detected 48% (16/33) of TBM. Based on these findings, a new cut-off point was proposed to differentiate probable (score ≥ 10) from possible (6 ≤ score ≤ 9) TBM. After score adjustment, there were 61 probable TBM with 26/33 (78.8%) TBM, and among the 109 possible TBM there were 7/33(21.2%) confirmed cases. In both systems, there were 130 non-TBM (score ≤ 5) and no confirmed TBM. The association of adjusted score (≥ 10) and CSF-PCR showed high sensitivity (90.9%) and specificity (86.9%), positive and negative predictive value of 46.2% and 98.9%, respectively. The combination of CSF-PCR and TBM score is a useful tool for the management of adults under investigation of TBM, but the best cut-off point may need local/regional adjustments.

Asthma is under-diagnosed in many parts of the world. We aimed to assess the outcome of a capacitating program on asthma for non-specialist physicians and other healthcare professionals working in the public system in Ribeirão Preto, Brazil.A group of 16 asthma specialists developed a one-year capacitating program in 11 healthcare clinics in the Northern District of the city, which included lectures on asthma, training on inhalation device use and spirometry, and development of an asthma management protocol. Researchers visited one health unit 2-4 times monthly, working with doctors on patients' care, discussing cases, and delivering lectures. Asthma education was also directed to the general population, focusing on recognition of signs and symptoms and long-term treatment, including production of educational videos available on YouTube. Outcome measures were the records of doctors' prescriptions of individual asthma medications pre- and post-intervention.Prior to the program, 3205 units of inhaled albuterol and 2876 units of inhaled beclomethasone were delivered by the Northern District pharmacy. After the one-year program, there was increase to 4850 units (51.3%) for inhaled albuterol and 3526 units (22.6%) for inhaled beclomethasone. The albuterol increase followed the recommendation given to the non-specialist doctors by the asthma experts, that every patient with asthma should have inhaled albuterol as a rescue medication, by protocol. No increase was observed in other districts where no capacitating program was conducted.A systematic capacitating program was successful in changing asthma prescription profiles among non-specialist doctors, with increased delivery of inhaled albuterol and beclomethasone.

The objective of this study was to evaluate risk factors for persistent wheezing in a group of 2-4-year-old children after an index-wheezing episode in infancy. Eighty infants who had been seen at the Emergency Department for an episode of acute wheezing were followed for 2 yr in this prospective study. Caregivers completed a questionnaire, and children underwent clinical evaluation and skin prick testing 2 yr following the index-wheezing episode. Detection of respiratory viruses and analysis of exposure to major indoor allergens were carried out at enrollment. Immunoglobin E antibodies were measured at the beginning of the study and at the end of follow-up, using the CAP system. Logistic regression analysis was performed to identify factors associated with persistent wheezing. Seventy-three children (44 boys) completed the study. After 2 yr, 38 (52%) reported three or more wheezing episodes in the past 12 months (persistent wheezers). Independent risk factors for persistence of wheezing were allergic sensitization and exposure to cockroach allergen in the kitchen. Breast-feeding for at least 1 month was a protective factor. A strong association between allergic sensitization and persistence of wheezing was found in a group of very young children living in a subtropical area.

Background Risk factors for acute wheezing among children in subtropical areas are largely unknown. Objective To investigate the role of viral infections, allergen sensitization, and exposure to indoor allergens as risk factors for acute wheezing in children 0 to 12 years old. Methods One hundred thirty-two children 0 to 12 years of age who sought emergency department care for wheezing and 65 children with no history of wheezing were enrolled in this case-control study. Detection of respiratory syncytial virus antigen, rhinovirus and coronavirus RNA, adenovirus, influenza, and parainfluenza antigens was performed in nasal washes. Total IgE and specific IgE to mites, cockroach, cat, and dog were measured with the CAP system. Major allergens from mites, cockroach, cat, and dog were quantified in dust samples by ELISA. Univariate and multivariate analyses were performed by logistic regression. Results In children under 2 years of age, infection with respiratory viruses and family history of allergy were independently associated with wheezing (odds ratio, 15.5 and 4.2; P = .0001 and P = .008, respectively). Among children 2 to 12 years old, sensitization to inhalant allergens was the major risk factor for wheezing (odds ratio, 2.7; P = .03). High-level allergen exposure, exposure to tobacco smoke, and lack of breast-feeding showed no association with wheezing. Conclusions Some risk factors for wheezing previously identified in temperate climates were present in a subtropical area, including respiratory syncytial virus infection in infants and allergy in children older than 2 years. Rhinovirus was not associated with wheezing and did not appear to be a trigger for asthma exacerbations.

Objetivo: Caracterizar o uso de medicamentos por homens cadastrados em uma Unidade de Saude da Familia (USF) de Ribeirao Preto, Sao Paulo. Materiais e Metodos: Estudo transversal descritivo com amostra de conveniencia composta por 84 homens cadastrados na USF estratificada em faixas etarias: Grupo 1 (G1) – 30 homens com idades de 20 a 39 anos, Grupo 2 (G2) – 13 homens com idades entre 40 e 49 anos, Grupo 3 (G3) – 13 homens com idades entre 50 e 59 anos e Grupo 4 (G4) com 28 homens de idade igual ou superior a 60 anos. Realizou-se entrevista a partir de um questionario semiestruturado com variaveis sociodemograficas, economicas, clinicas, acesso e utilizacao dos servicos de saude, uso de medicamentos e adesao ao tratamento. Resultados: Baixa renda e escolaridade foram verificadas predominantemente no G4. Hipertensao Arterial Sistemica foi a doenca autorreferida mais frequente, seguida da hipercolesterolemia e Diabetes Mellitus. Em todos os grupos, a maioria dos entrevistados relatou utilizar a USF e adquirir os medicamentos em Farmacias na Rede Publica de Saude. Verificou-se boa adesao ao tratamento medicamentoso e concordância entre doencas autorreferidas e medicamentos prescritos. O aumento da idade evidenciou associacao com: numero de doencas, utilizacao dos servicos de saude, utilizacao da USF e participacao no Grupo de Promocao a Saude do Homem. Conclusao: A caracterizacao desta amostra vem contribuir para avancos no conhecimento de aspectos relacionados a saude do homem e enfatizar que o uso racional de medicamentos deve ser uma preocupacao constante das equipes, gerentes e gestores da saude.

Methods Sixty one of 76 children who participated in a previous study (Camara et al JACI 2004;113;551-7) aimed at identifying risk factors for acute wheezing in infancy were re-evaluated at the ages of 2-4 and 8-12 years. They had been seen at the Emergency Room (ER) for an episode of wheezing at the age of 6-24 months. At the age of 8-12 years, parents completed a questionnaire on respiratory symptoms; 52 children underwent skin prick testing with a panel of inhalant and food allergens and 48 performed methacholine challenge tests. Children were considered asthmatic at the age of 8-12 years if they presented previous physician-diagnosed asthma, or at least one of the following symptoms in the past 12 months: wheezing, cough or chest tightness with exercise, or dry cough without colds, accompanied by bronchial hyperresponsiveness, defined by a PC20

Health outcomes, education, healthcare delivery and quality – 3051. Profiles of diagnosis and treatment of asthma in the public health system in Brazil Janaina M Melo, Adriana S Moreno, Virginia PL Ferriani, Elcio Vianna, Marcos Borges, Persio Roxo Jr, Ana Carla S Araujo, Luane M Mello, Rosa Ferreira, Jorgete M Silva, Patricia Stefanelli, Marcos R Goncalves, Larissa P Oliveira, Andrea Cetlin, Luana B Queiroz, Rosangela Villela, Davi C Aragon, L Karla Arruda

Severe Combined Immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency (PID). Complications of BCG vaccination, especially disseminated infection and its most severe forms, are known to occur in immunodeficient patients, particularly in SCID. A carefully taken family history before BCG injection as well as delaying vaccination if PID is suspected could be a simple and effective method to avoid inappropriate vaccination of an immunodeficient child in some cases until the prospect of newborn screening for SCID has been fully developed. We describe a patient with a very early diagnosis of SCID, which was suspected on the basis of the previous death of two siblings younger than one year due to severe complications secondary to the BCG vaccine. We suggest that a family history of severe or fatal reactions to BCG should be included as a warning sign for an early diagnosis of SCID.

Rationale We have evaluated risk factors associated with persistence of wheezing beyond the first two years of life among children living in a subtropical area. Methods 80 children who had been seen at the Emergency Room for an episode of wheezing in the first 2 years of life were followed for 2 years in this prospective study. Children underwent clinical evaluation and skin prick testing to inhalant and food allergens two years following the index episode of wheezing. Detection of respiratory viruses and analysis of house dust samples for exposure to major allergens from mites, cockroach, cat and dog (by ELISA) were carried out at enrollment. Total IgE and specific IgE antibodies (Pharmacia CAP system) were measured at the beginning of the study and at the end of follow-up. Multivariate analysis was performed to identify factors associated with persistent wheezing. Results 73 children (44 boys) completed the study. After 2 years, 38 (52%) presented 3 or more wheezing episodes treated with beta-2 agonists in the past 12 months (persistent wheezers). Risk factors for persistence of wheezing were: family history of allergy (OR=48.6; p=0.03), exposure to levels of cockroach allergen Bla g 1 >2U/g in the kitchen (OR=7.6; p=0.03) and allergic sensitization at age 2-4 (OR=11.3; p=0.002). Breast-feeding for at least one month was a protective factor (OR=0.08; p=0.01). Conclusions Environmental exposure to high levels of cockroach allergen in infancy, sensitization to indoor allergens at age 2-4 and family history of allergy were strongly and independently associated with persistent wheezing in children.

Methods A group of 16 allergists/immunologists developed a capacitating program in 11 Public Health Units in the city of Ribeirao Preto, Brazil. The program comprised lectures on asthma and hands-on training on spirometry and use of inhalation devices; production of didactic material; and development of a protocol on management of asthma. Spacers and spirometry were provided. Each researcher visited one Health Unit 2-4 times a month, to accompany the non-specialist on patients’ visits to the clinic, perform case discussions, and deliver short lectures to the health professionals. Records of asthma medications provided to patients upon physicians’ prescription in the North Region were compared to those from three other Regions with no intervention.

Introdução: Evento adverso pós vacina (EAPV) é qualquer ocorrência médica indesejada após a vacinação, não possuindo necessariamente uma relação causal com o uso de uma vacina, no período de até 30 dias após a vacinação. A maior parte dos eventos adversos pós vacina descritos são leves e/ou esperados, oriundos da estimulação do sistema imunológico. Porém uma minoria dos casos evolui com eventos adversos graves, necessitando avaliação especializada. O ambulatório de reação vacinal da HC FMRP-USP recebe a demanda dos pacientes que necessitam de avaliação de risco para o processo de vacinação, seja por histórico de evento adverso pós vacina ou por fazer parte de grupo de risco para determinada vacina. Objetivo: Descrever a rotina de atendimento do ambulatório de reação vacinal do HC FMRP-USP (descrição dos casos, manejo das situações de risco e procedimentos realizados), durante o período de 14 julho de 2016 à 13 de junho de 2019. Método: Estudo retrospectivo descritivo realizado através de análise de prontuário eletrônico. Resultados: Foram analisados um total de 254 pacientes de todas as faixas etárias, 87 (34%) encaminhados após EAPV e 167 (66%) encaminhados para avaliação de risco à vacinação. Após avaliação dos casos houve contraindicação de vacina para 2 (0,8%) pacientes; 90 (35,4%) pacientes apresentavam risco de EAPV igual ao da população em geral, sendo encaminhados para seguimento em UBS; 150 (59,1%) pacientes foram encaminhados para procedimento de vacinação assistida; e 12 (4,7%) pacientes não apresentavam necessidade de mais dose da vacina envolvida no EAPV relatado. Foram realizados 153 procedimentos de vacinação assistida, e houve apenas 4 (2,6%) eventos adversos leves após o procedimento. Conclusão: O presente estudo corrobora a ampla segurança das vacinas adotadas pelo Programa Nacional de Imunização à medida que identifica incidência muito baixa de reações adversas pós-vacinais mesmo em uma população de risco mais elevado para tais ocorrências. Introduction: Adverse post-vaccine event (APV) is any undesired medical occurrence after vaccination, not necessarily having a causal relationship with the use of a vaccine, within a period of up to 30 days after vaccination. Most of the post-vaccination adverse events described are mild and/or expected, arising from the stimulation of the immune system. However, a minority of cases evolve with serious adverse events, requiring specialized evaluation. The HC FMRP-USP vaccine reaction outpatient clinic receives the demand of patients who need a risk assessment for the vaccination process, either because of a history of post-vaccination adverse events or because they are part of a risk group for a particular vaccine. Objective: To describe the routine care of the vaccine reaction outpatient clinic of the HC FMRP-USP (case description, management of risk situations and procedures performed), during the period from July 14, 2016 to June 13, 2019. Method: Descriptive retrospective study, carried out through analysis of electronic medical records. Results: A total of 254 patients of all age groups were analyzed, 87 (34%) referred after APV and 167 (66%) referred for risk assessment for vaccination. After evaluating the cases, there was a contraindication for the vaccine for 2 (0.8%) patients; 90 (35.4%) patients had an APV risk equal to that of the general population and were referred to the basic health unit; 150 (59.1%) patients were referred for assisted vaccination procedure; and 12 (4.7%) patients didn´t need more doses of the vaccine involved in the reported APV. A total of 153 assisted vaccination procedures were performed, and there were only 4 (2.6%) mild adverse events after the procedure. Conclusion: The present study corroborates the broad safety of the vaccines adopted by the National Immunization Program as it identifies a very low incidence of post-vaccination adverse reactions even in a population at higher risk for such occurrences.

São Paulo é uma cidade global que concentra os maiores fluxos migratórios que chegam ao Brasil. A ausência de uma política migratória inclusiva não facilita e, muitas vezes dificulta, o acesso à saúde, direito do imigrante. Dessa forma, o presente estudo busca identificar as características associadas às populações de imigrantes e de não imigrantes acometidas pela tuberculose, residentes na cidade de São Paulo, bem como mostrar a dificuldade para a obtenção de dados para análise. Trata-se de um estudo descritivo, tipo levantamento. A população do estudo foi constituída por todos os casos de TB notificados durante o ano 2016. Para o estudo, foram utilizadas variáveis sociodemográficas, clínicas, de diagnóstico e de tratamento, obtidas pelo banco dados TB-WEB. Na análise dos dados, foram utilizadas técnicas de análise descritiva e testes estatísticos qui-quadrado com análise de resíduo padronizado e Mann Whitney para identificar as características associadas às populações de imigrantes versus não imigrantes. Os resultados encontrados possibilitam a melhor compreensão de variáveis de diagnóstico, clínicas, sociodemográficas e, também, variáveis de tratamento para o grupo de imigrantes no ano 2016 através da análise e discussão das associações encontradas, de forma a contribuir para o melhor conhecimento da dinâmica da TB nesse grupo e para o desenvolvimento de políticas e programas de saúde mais adequados e voltados para essa população São Paulo is a global city that concentrates the largest migratory flows coming to Brazil. The absence of a comprehensive migration policy does not help and often difficult, access to health care, immigrant right. Thus, this study seeks to identify the characteristics associated with populations of immigrants and non-immigrants affected by tuberculosis, in the city of São Paulo, as well as show the difficulty to obtain data for analysis. This is a descriptive, survey-type study. The study population consisted of all TB cases reported during the year 2016. For the study, sociodemographic, clinical, diagnostic and treatment variables obtained by the database TB-WEB were used. In the analysis of the data, descriptive analysis techniques and chi-square statistical tests with standardized residue analysis and Mann Whitney were used to identify the characteristics associated to the populations of immigrants versus non-immigrants. The results allow a better understanding of diagnostic, clinical, sociodemographic and treatment variables for the group of immigrants in the year 2016 through the analysis and discusion of the associations found, in order to contribute to a better understanding of the dynamics of TB in this group and to the development of health policies and programs that are more adequate and focused on this population

A imunoglobulina E (IgE) tem papel central na patogênese das doenças alérgicas. É parte da resposta do tipo 2, e as citocinas IL-4 e IL-13 são essenciais para que haja produção deste isotipo de imunoglobulina. Produção de IgE é também induzida por parasitas intestinais, particularmente helmintos. O objetivo do presente estudo foi avaliar a contribuição de IgE específica para ácaros, barata, gato, cachorro e para o parasita Ascaris lumbricoides sobre os níveis de IgE total entre crianças de áreas distintas no Brasil. Anticorpos IgE para ácaros Dermatophagoides pteronyssinus e Blomia tropicalis; barata Blattella germanica; gato; cachorro; e A. lumbricoides foram medidos usando o sistema ImmunoCAP, e comparados à IgE total no soro de 150 crianças de 3-6 anos de idade vivendo na cidade de Natal, endêmica para parasitoses intestinais, e de 54 crianças de 3-6 anos de idade com asma e/ou rinite, vivendo em Ribeirão Preto. Níveis de IgE total foram significantemente mais elevados em crianças de Natal quando comparados aqueles em crianças de Ribeirão Preto (média geométrica 630,9 kU/L, faixa 19,6-63.290 kU/L; e 398,1 kU/L, faixa 35,7-4.803 kU/L, respectivamente). Entre as 150 crianças de Natal, 52(34,6%) apresentaram IgE positiva para D.pteronyssinus; 70(46,6%) para B.tropicalis; 45(30%) para barata; 19(12,6%) para gato; 17(11,3%) para cachorro; e 125(83,3%) para A.lumbricoides. Entre as 54 crianças com asma e/ou rinite de Ribeirão Preto, 41(75,9%) apresentaram IgE positiva para D.pteronyssinus; 34(62,9%) para B.tropicalis; 22(40,7%) para barata; 11(20,3%) para gato; 12(22,2%) para cachorro. Embora estas crianças fossem negativas para parasitas à inclusão no estudo, 22(40,7%) tinham IgE para A.lumbricoides. Anticorpos IgE para A. lumbricoides foram mais elevados entre crianças de Natal, quando comparados a IgE para alérgenos inalantes (p